Reliability and validity of the Chinese version of the Scale for Assessment and Rating of Ataxia

Background The Scale for the Assessment and Rating of Ataxia （SARA） was shown to be a reliable and valid measurement for patients with spinocerebellar ataxia （SCA）. The Brazilian version and the Japanese version of SARA were favorable for good reliability and validity. This study aimed to translate SARA into Chinese and test its reliability and validity in measurement of cerebellar ataxia. Methods SARA was translated into Chinese. A total 39 patients with degeneration cerebellar ataxia were evaluated independently by two neurologists with the Chinese version of SARA. Then the patients were evaluated by one of above neurologists with International Cooperative Ataxia Rating Scale （ICARS）. The statistical analyses were performed using SPSS 17.0 for Windows. Results The Cronbach＇s alpha coefficient of the Chinese version of SARA was 0.78, which represents a good internal consistence. The correlation coefficient of the Chinese version of SARA scores between the two evaluators was 0.86, illustrating that the inter-rater reliability of Chinese version of SARA was good. The correlation coefficient between the Chinese version of SARA and ICARS was 0.91, illustrating that the criterion validity of Chinese version of SARA was not bad. Conclusions The Chinese version of SARA is reliable and effective for the assessment of degeneration cerebellar ataxia. Compared with ICARS, the evaluation of Chinese version of SARA is more objective, the assessment time is shortened, and the maneuverability is better.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.

Assessment of hindlimb motor recovery affer severe thoracic spinal cord injury in rats: classification of CatWalk XT■ gait analysis parameters

Assessment of locomotion recovery in preclinical studies of experimental spinal cord injury remains challenging. We studied the CatWalk XT■gait analysis for evaluating hindlimb functional recovery in a widely used and clinically relevant thoracic contusion/compression spinal cord injury model in rats. Rats were randomly assigned to either a T9 spinal cord injury or sham laminectomy. Locomotion recovery was assessed using the Basso, Beattie, and Bresnahan open field rating scale and the CatWalk XT■gait analysis. To determine the potential bias from weight changes, corrected hindlimb(H) values(divided by the unaffected forelimb(F) values) were calculated. Six weeks after injury, cyst formation, astrogliosis, and the deposition of chondroitin sulfate glycosaminoglycans were assessed by immunohistochemistry staining. Compared with the baseline, a significant spontaneous recovery could be observed in the CatWalk XT■parameters max intensity, mean intensity, max intensity at%, and max contact mean intensity from 4 weeks after injury onwards. Of note, corrected values(H/F) of CatWalk XT■parameters showed a significantly less vulnerability to the weight changes than absolute values, specifically in static parameters. The corrected CatWalk XT■parameters were positively correlated with the Basso, Beattie, and Bresnahan rating scale scores, cyst formation, the immunointensity of astrogliosis and chondroitin sulfate glycosaminoglycan deposition. The CatWalk XT■gait analysis and especially its static parameters, therefore, seem to be highly useful in assessing spontaneous recovery of hindlimb function after severe thoracic spinal cord injury. Because many CatWalk XT■parameters of the hindlimbs seem to be affected by body weight changes, using their corrected values might be a valuable option to improve this dependency.

Analysis of Beijing Oral English Certificate Test

Nowadays, assessing speaking has received a great degree of attention not only because it is difficult to develop and administer, but also it plays a significant role in eliciting the purpose of foreign language learning. Studies on assessing speaking explored different proposals influencing the test of speaking, such as the nature of speaking, basic types of speaking, mode of test and rating scales. This study compares different proposals for assessing speaking in foreign language learning. Deep analyses according to Beijing Oral English Certificate(BOEC) testing will be presented with the improvement suggestions.

How does a real-world child psychiatric clinic diagnose and treat attention deficit hyperactivity disorder?

AIM: To investigate child and adolescent psychiatrists'(CAPs) attention deficit hyperactivity disorder(ADHD) and oppositional defiant disorder(ODD) diagnoses and treatments in real-world clinical practice. METHODS: The medical records of 69 ADHD children(mean age = 9.5 years), newly referred to the ADHD clinic, were reviewed for their scores of parent- and teacher-reported Vanderbilt ADHD Diagnostic Rating Scales(VADRSs), CAPs' diagnoses of ADHD and ODD, and CAPs' treatment recommendations. Among 63 ADHD subjects who completed both parent and teacher VADRSs, we examined the agreement of the parent and teacher VADRSs. We also examined the concurrent validity of CAPs' ODD diagnoses against the results from the VADRSs. In addition, we compared CAPs' treatment recommendations against established ADHD and ODD guidelines.RESULTS: Among 63 ADHD subjects, the majority of the subjects(92%) met full ADHD diagnostic criteria at least in one setting(parent or teacher) on the VADRSs. Nearly half of the patients met full ADHD diagnostic criteria in two settings(parent and teacher). Relatively low agreement between the parent and teacher VADRSs were found(95%CI:-0.33 to 0.14). For 29 children who scored positive for ODD on the rating scales, CAPs confirmed the ODD diagnosis in only 12 of these casepositives, which is considered as a fair agreement between CAPs and VADRSs(95%CI: 0.10-0.53). For 27 children with no ODD diagnosis made by either CAP or VADRS, more than half of them were recommended for medication only. In contrast, where CAPs made the diagnosis of ODD, or where the parent or teacher VADRS was positive for ODD, almost all of the patients received recommendations for medication and behavior therapy.CONCLUSION: CAPs' ADHD diagnoses have strong concurrent validity against valid rating scales, but ADHD's most common comorbid condition- ODD- may be underrecognized.

Assessing an Educational Program to Improve Documentation and Reduce Pain in Hospitalized Patients

Few experimental studies have evaluated the efficacy of continuing educational programs aimed at the improvement of nurses’ pain-management skills. This study assessed whether a standardized educational program aimed at nurses could increase the use of the Numeric Rating Scale-11 in both documenting and reducing postoperative pain-intensity levels in hospitalized surgical patients. The study had a quasi-experimental pre- and post-intervention design. Data were collected from records of surgical patients prior to and after the standardized educational program was completed. There were no significant differences between pre- and post-intervention groups in terms of either pain-documentation frequency or pain-intensity level. The study showed no increase in the frequency of postoperative pain documentation and no reduction of surgical patients’ postoperative pain-intensity level. This finding indicates that the standardized educational program on postoperative pain management was insufficient to bring about changes in clinical practice.

Clinical challenges in the ataxias

Ataxias are rare diseases and the etiologic heterogeneity make individual entities even rarer.There are still substantial numbers of patients who are still poorly understood.Available assessment techniques still point to large numbers of patients needed for clinical trials and the need for cooperative efforts,better assessment tools and novel trial designs.Better understanding of neural circuitry abnormalities may lead to more effective symptomatic therapy.Opportunities exist for targeting at risk individuals for effective therapies but how this can be done is not clear.Preventive strategies may become feasible in many ataxias.

Observation on the Therapeutic Effect of Shangjinbitong Powder(伤筋痹痛散)on Improving Acupoint Plaster

Objective:To study the therapeutic effect of Shangjinbitong Powder(伤筋痹痛散)on improving acupoint plaster,in order to provide some scientific basis for clinical use.Methods:This project was carried out from June 2020 to January 2021,30 patients with low back pain in the outpatient department of orthopedics and traumatology in our hospital and 30 patients with low back pain in the rehabilitation department of Fuping County Hospital of Traditional Chinese Medicine were selected as the research objects.Patients with low back pain in our hospital were treated with Shangjinbitong Powder as the control group,and patients in rehabilitation department of Fuping County Hospital of Traditional Chinese Medicine as the research group were treated with acupoint plaster improved by Shangjinbitong Powder.After one week of treatment,the effective rates of the two groups were compared.Results:The effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05).There were no adverse reactions such as infection,scald and bleeding in the study group and the control group during the treatment.Conclusion:Shangjinbitong Powder improved acupoint plaster has good curative effect,convenient use,certain safety and clinical popularization value.

Nerve Growth Factor for the Treatment of Spinocerebellar Ataxia Type 3： An Open-label Study

Background： Spinocerebellar ataxia type 3 （SCA3） is the most common subtype of SCA worldwide, and runs a slowly progressive and unremitting disease course. There is currently no curable treatment available. Growing evidence has suggested that nerve growth factor （NGF） may have therapeutic effects in neurodegenerative diseases, and possibly also in SCA3. The objective of this study was to test the efficacy of NGF in SCA3 patients. Methods： We performed an open-label prospective study in genetically confirmed adult （〉18 years old） SCA3 patients. NGF was administered by intramuscular injection （18 μg once daily） fbr 28 days consecutively. All the patients were evaluated at baseline and 2 and 4 weeks after treatment using the Chinese version of the scale for assessment and rating of ataxia （SARA）. Results： Twenty-one SCA3 patients （ 10 men and 11 women, mean age 39.14 ± 7.81 years, mean disease duration 4.14 ± 1.90 years, mean CAG repeats number 77,57 ± 2.27） were enrolled. After 28 days of NGF treatment, the mean total SARA score decreased significantly from a baseline of 8.48± 2.40 to 6.30 ± 1.87 （P 〈 0.001 ）. Subsections SARA scores also showed significant improvements in stance （P = 0.003）, speech （P = 0.023）, finger chase （P = 0.015）, fast alternating hand movements （P = 0.009）, and heel-shin slide （P = 0.001）. Conclusions： Our preliminary data suggest that NGF may be effective in treating patients with SCA3.

四位一体多功能疼痛评估工具的研制和临床应用效果评价

目的设计一种新型四位一体多功能整合式疼痛评估工具并探讨其临床应用效果。方法选取我院2021-04-01/2021-06-01期间接收外科手术的患者300例,采用随机数字表法分为对照组(n=160)和观察组(n=140),对照组采用常规疼痛评估工具数字评分工具(NRS)、视觉模拟评估工具(VAS)、语言评分工具(VRS)或修订版面部表情疼痛评估工具(FPS-R))进行疼痛评估,观察组采用研制的四位一体多功能疼痛评估工具进行疼痛评估。评价2组患者首次疼痛评估所需要的时间和疼痛评估工具使用时的解释次数以及护士对疼痛评估工具的使用的满意度。结果NRS、VAS、VRS、FPS-R和多功能疼痛评估工具的应用正确评估时间分别为34.65±1.42,31.28±1.65,21.26±1.85,22.32±1.53,13.21±1.32,解释次数分别为1.90±0.10,1.45±0.08,1.13±0.06,1.16±0.05,1.03±0.02,采用Fisher精确概率法,P<0.05。护士对疼痛评估工具使用的总体评价比较,多功能疼痛评估工具的使用满意度优于常规疼痛评估工具的使用(P<0.05)。结论四位一体多功能疼痛评估工具可以提高护士的疼痛评估效率,提升工作满意度,值得临床推广应用。

4种疼痛评估量表在房颤射频消融术患者中的应用比较

目的比较4种疼痛评估量表在房颤患者射频消融术中的应用效果。方法选取160例接受射频消融术的房颤患者为研究对象,术中分别采用数字评定量表、视觉模拟评分、Wong-Baker面部表情疼痛量表、词语描述量表评估疼痛,比较不同疼痛评估量表在患者首选率、作答时间及效标效度方面的差异。结果4种疼痛评估量表在患者首选率、作答时间方面差异具有统计学意义(均P<0.05),Wong-Baker面部表情疼痛量表及词语描述量表患者首选率较高,而作答时间最短。不同性别、年龄及文化程度患者对4种疼痛量表首选率比较,差异无统计学意义(均P>0.05)。消融术中不同时间点词语描述量表、Wong-Baker面部表情疼痛量表、视觉模拟评分分别与数字评定量表(作为效标)评分存在高度相关(r=0.774~0.886,均P<0.05)。结论4种疼痛评估量表在房颤射频消融术中具有较好的疼痛评估作用,且Wong-Baker面部表情疼痛量表、词语描述量表的临床应用效果最佳。

评分量表介入大学英语写作教学评价实证研究

为了提升大学英语写作大班教学评价反馈效率,本研究探析评分量表在大学英语写作教学中的干预作用。根据研究需要,对照组遵循教材内容顺序突出写作技能的教学评价干预;实验组则围绕评分量表进行了为期10周的三明治干预式群组动态评价实践,包括基于评分量表的前后测、小组自评、互评、教师基于评分量表的书面反馈以及课堂纠错反馈。通过独立样本、配对样本T检验获得了量化数据,通过对观察和问卷调查结果的编码归纳获得了质性数据。研究结果表明,实验组与对照组写作成绩均取得了显著性进步,但实验组学习能动性及投入度提升更显著。评分量表起到了标准参考、诊断测评、中介干预、动态评价反馈等多维工具作用,并弥补了动态评价即时诊断的不足以及诊断评价与即时教学分离的不足。

Relative exchangeable copper,a high-quality biomarker for differentiation of Traditional Chinese Medicine syndrome in Wilson's disease

OBJECTIVE:To investigate the value of relative exchangeable copper(REC)in diagnosing Wilson's disease(WD)and to determine its significance in the differentiation of Traditional Chinese Medicine(TCM)syndrome.METHODS:A total of 78 patients with WD were recruited on the same day of the medical visit,and among them,32 were suffering from non-WD(N-WD)and 37 were heterozygous ATP7B carriers(HC)enrolled as controls.Molecular genetic testing was performed for diagnosing WD and HC.Additionally,REC levels in different TCM syndromes were investigated.The correlation between REC and serum ceruloplasmin(Cp),serum copper oxidase(CO),and 24-h urinary copper was analyzed using the Global Assessment Scale and Unified Wilson's Disease Rating Scale and the significance of REC in WD diagnosis was investigated.Resting-state functional magnetic resonance imaging was used to assess the clinical symptoms of WD and analyze its severity in different TCM syndromes.RESULTS:REC determination helped in significantly distinguishing patients with N-WD or HC from those with WD with a cut-off of 21.15%.Furthermore,the comparative analysis of REC ratios among different TCM syndromes showed markedly high REC levels in the dampness-heat internal accumulation syndrome group.Additionally,the seed-based functional connectivity value from the putamen to the cerebellum was significantly correlated with TCM syndromes.CONCLUSION:REC level is a high-quality biomarker for diagnosing WD that effectively reflects disease severity and plays an essential role in deciding on treatment strategies and prognosis.Furthermore,REC levels are closely related to TCM syndromes in WD;thus,it is a potential objective quantitative indicator for distinguishing TCM syndromes in WD.

Major Clinical Features and Epidemic Characteristics of Erosive Vulvar Lichen Planus:A Retrospective Analysis

Objective:Vulvar lichen planus(VLP),especially erosive VLP(EVLP),seriously affects women’s physiological function and quality of life.A retrospective analysis of erosive vulvar lichen planus(EVLP)was performed to raise awareness on this chronic,deforming,and painful vulvar disease.Methods:This observational retrospective study involved 40 patients with EVLP among 1,368 patients with vulvar disease from 2017 to 2020.The patients’vulvar clinical features and extravulvar mucosal involvement were investigated.The patients’pain and quality of life were evaluated with the numeric rating scale and the Dermatology Life Quality Index(DLQI),respectively.Clinical characteristics were reported using frequencies and proportions for categorical variables.Continuous variables are expressed as mean±standard deviation.The association between NRS score for pain and DLQI score was analyzed by Pearson’s correlation test.Results:EVLP accounted for 2.9%(40/1,368)of all cases of vulvar disease,and the median age at onset was 42 years.Erosion mostly occurred on the labia minora and introitus.Half(20/40)of the patients had extravulvar mucosal involvement.Seventeen(42.5%)patients had oral lichen planus,and seven(17.5%)patients were diagnosed with vulvovaginal-gingival syndrome.The numeric rating scale score showed that 47.5%(19/40)of patients experienced mild pain,whereas 12.5%(5/40)described the pain as severe.Thirty-one patients(77.5%,31/40)had dyspareunia,and nine patients had aggravated pain after sexual intercourse.The mean DLQI score was 9.1±6.0,with 37.5%(15/40)of patients indicating that EVLP had severely affected their lives.The numeric rating scale score for pain was significantly correlated with the DLQI score(P=0.007).Conclusion:EVLP can affect the quality of women’s lives and cause severe deformations and painful architectural changes.The description of the characteristics of EVLP in this report will benefit the diagnosis and early treatment of this disease.

天麻素联合胞磷胆碱治疗后循环缺血性眩晕临床研究

目的:观察天麻素联合胞磷胆碱治疗后循环缺血性眩晕(PCIV)的疗效。方法:回顾性选取PCIV患者104例,根据治疗方案不同分为对照组50例和联合组54例。2组均接受常规干预治疗,对照组在常规干预治疗基础上给予胞磷胆碱钠胶囊口服治疗,联合组在对照组基础上给予天麻素注射液治疗。2组均治疗14 d。评价2组临床疗效,比较2组治疗前后眩晕评定量表评分系统(DARS)评分、眩晕障碍量表的筛查表(DHI-S)评分、脑动脉血流速度及血液流变学指标[血浆黏度(PV)、全血高切黏度(HSV)、全血低切黏度(LSV)、红细胞比容(Hct)],统计2组不良反应发生情况。结果:联合组总有效率为96.30%,高于对照组78.00%(P<0.05)。治疗后,2组DARS评分与DHI-S评分均较治疗前降低(P<0.05),且联合组DARS评分与DHI-S评分均低于对照组(P<0.05)。治疗后,2组基底动脉平均血流速度、左侧椎动脉平均血流速度及右侧椎动脉平均血流速度均较治疗前升高(P<0.05),且联合组基底动脉平均血流速度、左侧椎动脉平均血流速度及右侧椎动脉平均血流速度均高于对照组(P<0.05)。治疗后,2组PV、HSV、LSV及Hct均较治疗前降低(P<0.05),且联合组PV、HSV、LSV及Hct均低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:天麻素联合胞磷胆碱治疗PCIV患者临床疗效显著,可能通过改善患者血液流变学指标进而缓解眩晕症状。

癌症住院患者疼痛强度描述语的对应量化研究

目的比较癌症患者主诉疼痛强度描述语评分与疼痛数字评分量表(Numeric Rating Scales,NRS)评分的相关性和一致性,为临床准确评估疼痛提供参考。方法采用横断面问卷调查法,对1120例癌症患者采用自制疼痛强度描述语对应量化问卷进行调查。以NRS作为效标,比较患者主诉疼痛强度描述语在患者疼痛评估中的灵敏性。结果共收集了24个疼痛强度描述语,患者主诉疼痛描述语评分与NRS评分呈显著正相关(r=0.937,P<0.001);Bland-Altman分析显示,患者主诉疼痛描述语评分与NRS评分一致性较高(平均差值0.2,95%CI-2.06~2.47)。结论患者主诉疼痛描述语能够准确反映患者疼痛强度,通过将患者的疼痛主诉描述与NRS评分相对应,结合主观描述和客观量化,可为医护人员提供更直观的方式来理解和评估患者的疼痛程度,提高疼痛评估的准确性。

艾灸疗法对脾肾阳虚型腹膜透析患者胃肠功能障碍的影响

目的:观察艾灸疗法对脾肾阳虚型腹膜透析患者胃肠功能障碍的疗效,并探讨相关机制。方法:将72例脾肾阳虚型腹膜透析胃肠功能障碍患者按随机数字表法分为对照组和艾灸组各36例,最终69例患者完成研究,对照组35例,艾灸组34例。两组患者均接受西医常规基础治疗,艾灸组患者在此基础上接受艾灸足三里、三阴交治疗。两组均以4周为1个疗程,持续治疗3个疗程。比较两组治疗前后的胃肠道症状分级量表(GSRS)评分、主观整体营养评估(SGA)评分及血清胃泌素(GAS)、胃动素(MOT)、胆囊收缩素(CCK)水平,评价两组胃肠道症状疗效。结果:治疗后,两组GSRS评分均较治疗前降低,SGA评分均较治疗前升高,血清GAS、MOT、CCK水平均较治疗前降低,差异均有统计学意义(P<0.01)。治疗后,艾灸组GSRS评分低于对照组,SGA评分高于对照组,血清GAS、MOT、CCK水平低于对照组,差异均有统计学意义(P<0.05)。艾灸组胃肠道症状总有效率高于对照组,两组胃肠道症状疗效比较,差异有统计学意义(P<0.05)。结论:艾灸疗法能缓解脾肾阳虚型腹膜透析患者的胃肠道症状,改善其营养状态,作用机制可能与调节GAS、MOT、CCK水平有关。

改良的患者参与主观全面评定量表在大肠癌患者营养评定中的应用

目的:探讨大肠癌患者在营养评定中应用改良的患者参与的主观全面评定量表效果。方法:选取2022年10月—2023年10月贵州中医药大学第一附属医院收治的78例大肠癌患者作为研究对象,按照随机数表法进行分组,对照组39例采用常规患者参与的主观全面评定量表进行营养评定,研究组39例中应用改良的患者参与的主观全面评定量表进行营养评定。根据营养评定结果,对患者采取针对性的营养干预措施,观察两组的干预效果。结果:研究组干预后的蛋白质以及能量摄入效果较对照组更高,各项营养状况指标较对照组更高,炎性因子水平较对照组更低,不良反应发生率较对照组更低,差异有统计学意义(P<0.05)。结论:对大肠癌患者在营养评定中应用改良的患者参与的主观全面评定量表,能够更为准确地评估患者的营养状态,具有推广价值。

“长海痛尺”在疼痛评估中的应用

目的 探讨“长海痛尺”在临床应用中的可行性和实用性。方法 设计“长海痛尺”并将其应用于临床 6个月后 ,调查评估者及患者对此量表的评价。结果 疼痛评估者对“长海痛尺”的满意度为 88.2 8% ,患者对“长海痛尺”的满意度为 90 %。结论 “长海痛尺”设计合理 ,使用方便 ,在疼痛评估时能更好地满足医护人员及患者的需要。

精神病人刑事责任能力影响因素研究

目的研究精神病人刑事责任能力影响因素。方法用湖南医科大学精神卫生研究所编制的精神病人责任能力评定量表,对司法部司法鉴定中心2001年鉴定的159例刑事责任能力评定案件进行回顾性资料分析。结果该量表的绝大多数条目在不同责任能力组差异均达统计学显著性水平,对作案行为的罪错性认识、作案现实动机、自我控制能力损害、自知力损害、作案时间选择性、现实检验能力损害、生活自理能力损害、工作或学习能力损害等是影响其辨认能力和控制能力的主要因素,以对作案行为的罪错性认识、作案现实动机、自知力损害等因素更为明显。结论责任能力评定量表可为精神病人责任能力评定提供相对可靠的客观依据。